Provider Demographics
NPI:1598966632
Name:MEDINA, RACHEL Y (CAS)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:Y
Last Name:MEDINA
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 N STOVER ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-3925
Mailing Address - Country:US
Mailing Address - Phone:559-635-2166
Mailing Address - Fax:
Practice Address - Street 1:1300 S CROWE ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-2106
Practice Address - Country:US
Practice Address - Phone:559-734-5480
Practice Address - Fax:559-734-5783
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)